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54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

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Trends in preoperative pain management - a survey of two collectives with coxarthrosis

Meeting Abstract

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  • corresponding author V. Kreckel - Grevenbroich
  • P. Eysel - Köln
  • D.P. König - Köln

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novFJW1

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/nov2005/05nov048.shtml

Published: June 13, 2005

© 2005 Kreckel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Introduction

Pain management of coxarthrosis can be improved by assessing its trends and problems.

Method

A total of 406 patients with coxarthrosis-related hip arthroplasty in 1990-93 (n=205) and 2002-03 (n=201) were analysed for the duration of coxarthrosis, pharmacotherapy and conditions associated with a higher risk of adverse effects during a nonsteroidal anti-inflammatory therapy (NSAIDs and coxibs).

Results

The majority (1990-93: 73%, 2002-03: 79%) underwent total hip replacement within five years after onset of osteoarthritis related problems. Half of the patients received painkillers. NSAIDs predominated although 75% of the patients in both groups were at risk for gastric and/or renal adverse

effects. Almost every second risk patient in 1990-93 and 2002-03 received an NSAID (including coxibs). In contrast to 1990-93 NSAIDs were prescribed in combination with gastric protective medication in the time period 2002-03. Out of all prescribed NSAIDs in 2002-03, 20% were selective COX-II-inhibitors. There was an increase (+9%) of opioid medication in the latter period.

Discussion

Despite a substantial risk of adverse effects and interactions, which often goes unnoticed, the use of NSAIDs is widespread. Opioid analgetics are increasingly prescribed with a positive effect on osteoarthritis related pain and with a favourable safety profile. The aim is a patient-orientated pain

management with careful consideration of risks and benefits.